title: Sarcopenia and change in body composition following maximal androgen suppression with abiraterone in men with castration-resistant prostate cancer.
abstract: BACKGROUND
  Standard medical castration reduces muscle mass. We sought to characterize body composition changes in men undergoing maximal androgen suppression with and without exogenous gluocorticoids.
  
  
  METHODS
  Cross-sectional areas of total fat, visceral fat and muscle were measured on serial CT scans in a post-hoc analysis of patients treated in Phase I/II trials with abiraterone followed by abiraterone and dexamethasone 0.5 mg daily. Linear mixed regression models were used to account for variations in time-on-treatment and baseline body mass index (BMI).
  
  
  RESULTS
  Fifty-five patients received a median of 7.5 months abiraterone followed by 5.4 months abiraterone and dexamethasone. Muscle loss was observed on single-agent abiraterone (maximal in patients with baseline BMI >30, -4.3%), but no further loss was observed after addition of dexamethasone. Loss of visceral fat was also observed on single-agent abiraterone, (baseline BMI >30 patients -19.6%). In contrast, addition of dexamethasone led to an increase in central visceral and total fat and BMI in all the patients.
  
  
  CONCLUSIONS
  Maximal androgen suppression was associated with loss of muscle and visceral fat. Addition of low dose dexamethasone resulted in significant increases in visceral and total fat. These changes could have important quality-of-life implications for men treated with abiraterone.
authors.affiliation: Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton, Surrey, UK.
authors.forename: C
authors.initials: C
authors.lastname: Pezaro
authors.forename: D
authors.initials: D
authors.lastname: Mukherji
authors.forename: N
authors.initials: N
authors.lastname: Tunariu
authors.forename: A M
authors.initials: AM
authors.lastname: Cassidy
authors.forename: A
authors.initials: A
authors.lastname: Omlin
authors.forename: D
authors.initials: D
authors.lastname: Bianchini
authors.forename: G
authors.initials: G
authors.lastname: Seed
authors.forename: A H M
authors.initials: AH
authors.lastname: Reid
authors.forename: D
authors.initials: D
authors.lastname: Olmos
authors.forename: J S
authors.initials: JS
authors.lastname: de Bono
authors.forename: G
authors.initials: G
authors.lastname: Attard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D000736:Androstenes; D000737:Androstenols / Q000008:administration & dosage / Q000009:adverse effects*; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000009:adverse effects; D001823:Body Composition / Q000187:drug effects*; D006801:Humans; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D009919:Orchiectomy; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery; D012189:Retrospective Studies; D055948:Sarcopenia / Q000139:chemically induced* / Q000453:epidemiology; D017211:Treatment Failure
chemical_list: D000726:Androgen Antagonists; D000736:Androstenes; D000737:Androstenols; D018931:Antineoplastic Agents, Hormonal; C089740:abiraterone